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目的回顾性分析高频振荡通气(HFOV)治疗新生儿持续肺动脉高压(PPHN)的疗效。方法对2010年1月至2014年6月连云港市第一人民医院NICU收治的25例PPHN患儿进行高频振荡通气,观察其治疗前后血气指标的变化及临床疗效。结果 25例患儿中1例死亡,2例放弃治疗,其余全部治愈。治疗后12 h通气氧合明显改善,二氧化碳分压(PCO2)由(75.35±10.20)mm Hg(1 mm Hg=0.133 k Pa)下降至(60.38±9.20)mm Hg,氧分压(PO2)由(38.75±8.20)mm Hg上升至(56.70±5.30)mm Hg,差异有统计学意义(P<0.01);治疗后24 h气道压力(Paw)明显下降,吸入氧浓度(Fi O2)明显降低,差异有统计学意义(P<0.01);治疗后肺动脉压力由(58.26±12.15)mm Hg下降至(24.43±13.78)mm Hg,差异有统计学意义(P<0.05)。结论 HFOV治疗PPHN效果好,在无NO吸入治疗的情况下可作为首选治疗方法。
Objective To retrospectively analyze the therapeutic effect of high frequency oscillatory ventilation (HFOV) on neonatal persistent pulmonary hypertension (PPHN). Methods From January 2010 to June 2014, 25 cases of PPHN patients admitted to NICU of Lianyungang First People’s Hospital were subjected to high-frequency oscillatory ventilation to observe the changes of blood gas indexes before and after treatment and the clinical effects. Results Of the 25 children, 1 died, 2 gave up treatment, and the rest were all cured. Ventilation oxygenation was significantly improved 12 h after treatment, and the PCO2 decreased from (75.35 ± 10.20) mm Hg (1 mm Hg = 0.133 k Pa) to (60.38 ± 9.20) mm Hg. The oxygen partial pressure (38.75 ± 8.20) mm Hg increased to (56.70 ± 5.30) mm Hg, the difference was statistically significant (P <0.01). After 24 hours, the airway pressure (Paw) decreased obviously and the FiO2 decreased significantly , The difference was statistically significant (P <0.01). After treatment, pulmonary artery pressure decreased from (58.26 ± 12.15) mm Hg to (24.43 ± 13.78) mm Hg, with significant difference (P <0.05). Conclusion The treatment of PPHN with HFOV is effective and can be used as the first choice of treatment in the absence of NO inhalation.